CPT 17273Surgery

Dstr mal les s/n/h/f/g 2.1-3

CPT 17273 covers the destruction of a malignant (cancerous) skin lesion on the scalp, neck, hands, feet, or genitals when the lesion measures between 2.1 and 3.0 centimeters in diameter. This typically involves using techniques like electrosurgery, cryotherapy, laser, or chemical treatments to remove skin cancer.

Showing rates for

National Average

Base Medicare rate

$203.46

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

2.1

PE RVU (NF)

3.98

MP RVU

0.21

Total RVU

6.29

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Accurately measure and document lesion size in centimeters in the medical record before destruction, as the difference between 17272 (≤2.0 cm) and 17273 (2.1-3.0 cm) affects reimbursement
Impact: $69.55 difference in Medicare non-facility payment between 17272 ($133.91) and 17273 ($203.46)
For multiple lesions, bill the largest lesion with CPT 17273 and use appropriate add-on codes (17274-17276 for larger, or subsequent codes for smaller) to maximize compliant reimbursement
Impact: Prevents downcoding and ensures capture of full procedure complexity; improper sequencing can result in $50-100+ in lost revenue per encounter
Verify prior pathology report confirming malignancy is attached or referenced in documentation, as many payers require histologic confirmation before destruction
Impact: Prevents medical necessity denials which represent 100% revenue loss ($203.46 per claim); expedites clean claims processing
Document the specific anatomic location (scalp, neck, hands, feet, genitalia) clearly, as codes 17260-17266 apply to other body areas with different reimbursement rates
Impact: Using incorrect code family (17260-17266 vs 17270-17276) can result in under-reimbursement of $30-80 per lesion depending on size
Distinguish between facility and non-facility settings when contracting with payers, as the $69.55 rate differential impacts practice revenue models
Impact: Non-facility rate ($203.46) vs facility rate ($133.91) represents 52% higher reimbursement; critical for ASC vs office decision-making
For lesions measuring exactly at size breakpoints (2.0 cm, 3.0 cm), document whether measurement includes margins and use clinical judgment with conservative coding to avoid audits

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Frequently asked questions

What is the difference between CPT 17273 and 17272?

CPT 17272 is used for malignant lesions measuring 2.0 cm or smaller, while 17273 covers lesions from 2.1 to 3.0 cm. Both apply only to lesions on the scalp, neck, hands, feet, or genitalia. The 2025 Medicare non-facility reimbursement difference is $69.55 ($133.91 for 17272 vs $203.46 for 17273), making accurate measurement documentation critical.

How much does Medicare pay for CPT code 17273 in 2025?

The 2025 Medicare national average payment is $203.46 for non-facility settings (office) and $133.91 for facility settings (hospital outpatient or ASC). Actual reimbursement varies by geographic locality adjustment and payer-specific fee schedules.

Can I bill CPT 17273 for multiple lesions?

Yes, but use modifier 51 for the second and subsequent lesions. The first (largest) lesion is billed at the full rate ($203.46), while additional lesions typically reimburse at 50% ($101.73). If destroying lesions of different sizes, sequence from largest to smallest and use the appropriate size-specific codes (17272, 17273, 17274, etc.).

Do I need a biopsy before billing 17273?

Yes, most payers including Medicare require pathologic confirmation of malignancy before destruction. You must have a prior biopsy report documenting basal cell carcinoma, squamous cell carcinoma, melanoma in situ, or other malignant diagnosis. Treating clinically suspected but unconfirmed lesions may result in medical necessity denials.

What body areas qualify for CPT 17273?

CPT 17273 applies exclusively to lesions on the scalp, neck, hands, feet, and genitalia (abbreviated as s/n/h/f/g in the code descriptor). For malignant lesions on the trunk, arms, legs, or face, use the 17260-17266 code series instead, which have different reimbursement rates.

What are the RVUs for CPT 17273 in 2025?

The 2025 total RVUs are 6.29, consisting of 2.1 work RVUs, 3.98 non-facility practice expense RVUs (1.83 facility PE RVUs), and 0.21 malpractice RVUs. These are multiplied by the 2025 conversion factor of 32.3465 to calculate Medicare payment rates.

Can CPT 17273 be billed with an E/M service on the same day?

Yes, but only if the E/M service is significant and separately identifiable from the decision to perform the destruction. Append modifier 25 to the E/M code and ensure documentation clearly shows the additional evaluation and management work beyond the procedure itself. The destruction decision alone does not justify a separate E/M unless substantial additional history, exam, or medical decision-making occurred.